1. Merging Two Centers -- Can It Solve Certain Problems? The merger of two centers with each other has not been a traditional strategy for surgery center growth over the past 10 years. Traditionally, merging two centers, absent certain motives such as redeeming certain physicians, has been viewed more as a negative than a positive. Mergers would often expand annual fixed costs and leave more physicians owning interests in two centers with less of a definite connection between the physicians that practice at the specific centers. For example, now you might have 40 physicians who have interests in two different centers instead of 20 physicians at each center who are highly tied to the centers. Notwithstanding this traditional hesitancy to merge centers, we are currently seeing a significant increased interest in the merger of surgical centers. For an article authored by Tom Yerden and Scott Becker that discusses a case study of a merger of two centers and explanation of some of the reasons a merger can be attractive, click here.

2. 10 Keys to Turning Around Financially Troubled ASCs. The healthcare sector is not immune to the weak economy and, as such, some ASCs may be finding themselves increasingly in financial trouble. This is the subject of a paper entitled "10 Keys to Turning Around Financially Troubled Ambulatory Surgery Centers: A Case Study Approach." Brent Lambert, MD, FACS, one of the founders of Ambulatory Surgical Centers of America, and Tom Mallon, the CEO of Regent Surgical Health, presented examples of some solutions for ASCs that are struggling financially. For the complete story, go here.

3. Five Business Challenges Orthopedic Practices Face. Don Love, the CEO of an orthopedic practice in Roanoke, Va., and Ken Austin, MD, an orthopedic surgeon in Ramsey, N.J., share their insights on key business challenges orthopedic physicians are currently facing. Five of the largest challenges facing orthopedic practices include (1) decreasing Medicare and Medicaid reimbursement; (2) decreasing third-party reimbursement; (3) difficulty recruiting physicians and staff; (4) increasing hospital competition and recruitment; and (5) the need to develop ancillary services and revenues. Go here for the complete story.

The July/Aug. issue of the Becker's ASC Review will feature 60 people to know in the ASC industry. Here is a preview of six of those key figures.

1. Jay Rom, MBA, CPA. Jay Rom is the president of Blue Chip Surgical Partners, which focuses on developing spine, ENT, sleep, radiosurgery and multi-specialty ASCs. Before joining Blue Chip, Mr. Rom served as CEO of a cardiology group in Cincinnati with 15 physicians and was vice president for physician services of the Franciscan Health System, where he was responsible for a 60-physician multi-specialty group. Mr. Rom was also a member of the start-up team, which created and launched a venture capital-backed physician practice management company based in Dayton, Ohio. He was once finance director/controller of a 200,000-plus member HMO that was acquired by United HealthCare, where he continued after the acquisition as an executive responsible for UHC's accounting and finance.

2. John Schario, MBA. John Schario is the president of Nueterra Healthcare, an industry leader in developing healthcare facilities. Mr. Schario brings together the extensive resources that allow Nueterra to develop, operate and nurture ambulatory care facilities including ASCs and surgical hospitals, as well as any other ambulatory care facilities created through partnerships. Before joining Nueterra in 2001, Mr. Schario worked for 20 years as an executive with a major Midwestern integrated health system. His managerial background includes the development and operation of ASCs, imaging facilities, and occupational medicine clinics. He has been instrumental in the development of Nueterra's corporate support services and their successful deployment across diverse business ventures with the company's physician partners. Mr. Schario is a member of the American College of Healthcare Executives.

3. Alsie Sydness-Fitzgerald, RN, CASC. Alsie Sydness-Fitzgerald is the chair of the ASC Association and participated in the development of the CASC (Certified Administrator Surgery Center) credential. She has been involved in the ASC industry since 1976 and has built up outstanding experience in the clinical, business and management aspects of the ASC industry as the director of clinical operations for HCA's Ambulatory Surgery Division. Ms. Sydness was formerly treasurer and secretary of FASA and served on the association's board of directors.

4. Allen Hecht, MBA. Allen D. Hecht is president of Health Resources International, which is engaged in developing ambulatory care programs in new and emerging markets. Mr. Hecht formerly served as executive VP and COO of ASC Network Corporation, a national surgical center company formed as a result of a merger between SunSurgery Corporation (formerly Medical Management and Development Corporation) and Premier Ambulatory Systems of Pasadena, Calif. Mr. Hecht was a principal, director and executive VP-COO of SunSurgery Corporation. Privately held ASC Network Corporation owned and operated 26 ASCs before being acquired by HealthSouth Corporation in 1997. Mr. Hecht has been integrally involved in the ambulatory surgical center industry since 1976: He assisted in developing one of the first ASCs in downtown Chicago. Mr. Hecht currently serves as immediate past chairman and is a member of the board of directors and the executive committee of the ASC Association. Mr. Hecht has participated in the Feasibility Study of a National Survey of Ambulatory Surgery for the CDC Center for Health Policy Studies and served for more than 25 years as a surveyor for the Accreditation Association for Ambulatory Health Care.

5. Debra Saxton Stinchcomb, RN, BSN, CASC. Debra Saxton Stinchcomb is the director of surgical services for Progressive Surgical Solutions, an ASC consulting company. She has 25 years' healthcare experience, including clinical, administrative, operations and sales. Ms. Saxton Stinchcomb has focused the last 11 years exclusively on ASCs, with an emphasis on multi-specialty centers. In that time, she has held positions s an ASC administrator, assistant regional VP and regional VP. Her responsibilities have included budget development and management, revenue and expense management, contract negotiation, licensing/certification/accreditation compliance, marketing, and risk management, quality improvement and benchmarking. Ms. Saxton Stinchcomb has been a AAAHC surveyor since 2001 and is a past president of the Arkansas Ambulatory Surgery Association.

6. John R. Seitz. In his position as the co-founder, chairman and CEO of Ambulatory Surgical Group, John R. Seitz oversees business development, the operational and financial management of all ambulatory surgical centers, and central business office services. For more than 25 years, Mr. Seitz has focused in the healthcare industry, earning the respect of physicians and industry executives; as a result, he is widely recognized in the ASC industry as a developer and manager of de novo ASC projects, has presented at numerous conferences (including The ASC 100), and has an extensive network of contacts in the industry. Before Ambulatory Surgical Group, Mr. Seitz had founded and either been CEO or president of three successful start-up companies in the healthcare industry. Most recently, as a co-founder and president of Surgem, he was responsible for building the ASC company from zero dollars in revenue to a current run-rate in excess of $50 million consolidated in less than three years, and he recruited the management team, directed the development and operation of eight ASC projects from planning through syndication to operations, and was responsible for the acquisition and turnaround of an under-performing center.

1. Suburban Boston Outpatient Center Opening Announced. AMB Development Group has recently completed the development of a 99,000-square-foot outpatient center in suburban Boston for Northeast Health System. This state-of-the-art center includes a surgery center, pain and spine center, 2T MRI, Breast MRI, 64-slice CT, nuclear and radiology, women's center, cardiovascular center, physical therapy and physician offices. The facility is anchored by the Lifestyle Management Institute, an integrated disease and lifestyle management clinic. AMB provided planning, programming, design, and engineering services. The entire facility received full department of health approvals within 24 hours of inspection, an exceptional outcome. AMB has recently commenced the development of another 100,000-square-foot outpatient center, also in a suburb of Boston. For more information, contact Jack Amormino, president and CEO of AMB, at (414) 291-4430.

2. Joint Commission to Provide Electronic Standards Manual. The Joint Commission will provide its organizations with an electronic edition of its standards manual beginning in November 2008, according to Michael Kulczycki, executive director of the Joint Commission's Ambulatory Care Accreditation Program. Go here for the complete story.

The 6th Annual Orthopedics, Pain Management and Spine Driven ASC Conference: Improving Profits, Legal and Business Issues, will be held June 19 to 21 in Chicago. This is an opportunity for great education and great networking. You can earn up to 13.5 CME and 13.5 CASC credits by attending. There are fewer than 25 attendee registrations available.

Download the complete program brochure and agenda here.

Here are just four of the valuable seminars you can attend if you register:

1. John C. Riddle will present a talk entitled "The Intersection of Healthcare and Wall Street: How the Capital Markets View ASCs and Healthcare."


2. George Goodwin, the chief development officer at Symbion, and Dr. Brett Taylor of the Orthopedic Center of St. Louis will speak on building a spine-driven ASC, specifically examining the Chesterfield Surgery Center.


3. Lt. Col. Bruce Bright, the director of business development at The Sanders Trust, will discuss healthcare real estate options.


4. Ann Geier, RN, MS, CNOR, CASC, a vice president of operations at ASCOA will talk about staffing strategies for ASCs and offer five tips for assembling an outstanding and cost-effective staff.

Download the complete program agenda and event brochure here. CME, CEU and CASC credits available. Paid subscribers to the Becker's ASC Review can receive a $100 discount. E-mail Rob Kurtz if you are a paid subscriber and would like to take advantage of this special offer. Additional discounts apply when registering two or more attendees.

There are four easy ways to register:

• Online. Register through our secure Web site.


• Fax. Complete the order form and fax it to (312) 706-2526. Please show ASC Communications c/o a5 as the subject line.


• Mail. Complete the order form and mail it to ASC Communications; c/o a5 Inc.; 1 N. LaSalle Street, 47th Floor; Chicago IL 60602.


• Phone. Call (312) 546-6042 to register.

What are the most effective means you use to reduce costs?

E-mail Rob Kurtz your thoughts to this question by clicking here. Be sure to include your name and business name.

In a few weeks, we will publish a selection of the responses we receive and choose one response as our "answer of the month." The winner will receive a free six-month subscription to Becker's ASC Review (current subscribers will receive an additional six months on their existing subscriptions).

Note: A computer glitch caused e-mail bounce-backs last week; please resubmit if this affected you. Thank you.

1. Hospital Leader Shares Insights on Current State of Hospitals and Healthcare. In just eight years, BayCare Clinic has become an extremely profitable, high-quality, physician-owned organization serving the Green Bay, Wis., community. The chief medical officer for BayCare is Paul Summerside, MD, FAAEM, who also serves as the president of the board of managers for Aurora BayCare Medical Center in Green Bay. To read Dr. Summerside's thoughts on the major challenges currently facing hospitals, why many hospitals are struggling to find sustainable success and what still keeps him excited about healthcare, go here.

2. Request for Referral: President, Hospital Division, Jackson Healthcare (Alpharetta, Ga.). The president, hospital division is a newly created position that reports to Richard L. Jackson, CEO, and is responsible for creating a business that acquires and manages hospitals. He/She will be charged with developing the feasibility of for-profit hospital acquisition and manage the business; designing the venture strategy and business model; leading the effort to identify acquisition candidates and their valuation; and leading the selection process for the hospitals' operations management teams. This is an outstanding opportunity to develop a business plan, identify acquisition candidates, lead the business deals, and later run the established division that is part of a dynamic, growing healthcare company. If you know of someone who may be interested, please e-mail Hallie Banker of Tyler & Company, or call her at (704) 845-2227.

This week we want to thank and highlight the following sponsors of the June Orthopedics-, Pain Management- and Spine-Driven ASC Conference, presented by ASC Communications.

1. VMG Health. VMG Health is recognized by leading healthcare providers as one of the most trusted valuation and transaction advisors in the United States. Whether circumstances call for a comprehensive valuation, the sale or acquisition of a facility, or joint-venture development assistance, VMG Health offers a unique and in-depth understanding of the relationships, requirements and business issues that surround today's healthcare facilities. The company is the senior leadership sponsor for the June conference. For more on VMG, click here.

2. Symbion. Headquartered in Nashville, Tenn., Symbion is a leading provider of high quality surgical services across many specialties. Led by one of the industry's most experienced management teams, the company was founded in 1996 to acquire, develop and operate outpatient surgery facilities in partnership with physicians, hospitals and health systems. Symbion is sponsoring the Friday evening networking reception. Learn more about the company here.

3. Serbin Surgery Center Billing/Surgery Consultants of America. With the Medicare ASC payment changes and the ever-changing complexity of ASC billing, many ASCs are looking for solutions to their billing and collection needs. Serbin Surgery Center Billing was founded in 2001 to provide the answer to this much-needed service. SCB concentrates on the unique needs of surgery centers and provides expert and accurate coding, billing, collections, and managed care negotiations solely to the ASC industry. The companies will sponsor the conference tote bags. Read more here

4. QSE Technologies. QSE Technologies is a premiere IT systems integrator serving the ambulatory healthcare industry for more than five years. QSE manages all aspects of IT infrastructure design, configuration, installation and ongoing tech support for new and existing ASCs nationwide. QSE will sponsor the cyber kiosks at the June conference. Learn more about the company's services here

5. Woodrum/ASD. Founded in 1986 by healthcare professional managers, Woodrum ASD is one of oldest continuing, national ASC companies in the U.S., having developed and managed ASCs in 46 states. Woodrum/ASD will be sponsor tote-bag drop-ins at the June conference. For more about Woodrum/ASD, click here.

6. Foundation Surgery Affiliates. Foundation Surgery Affiliates is a healthcare management organization specializing in project development, innovative facility design, partner recruitment and facility operations for ASCs, medical office buildings, surgical hospitals and bariatric hospitals and healthplexes. FSA will sponsor the labeled bottled water. Read more about the company here.

7. Eveia Health Consulting & Management Company. Founded by I. Naya Kehayes, MPH, Eveia Health Consulting & Management is comprised of a team of seasoned professionals who are experts in reimbursement management, managed care contracting, and business management with a specialization in ASCs and surgical practices. The company will sponsor the badge lanyards at the June conference. For more on Eveia, go here.

8. National Surgical Care. National Surgical Care, a nationwide owner and operator of ambulatory surgical centers, focuses on addressing the needs and problems confronting surgery centers across the country. NSC specializes in the acquisition and operational enhancement of existing surgery centers and the development of new surgery centers in partnership with hospitals and physicians. The company is sponsoring the conference-at-a-glance. Read more about NSC's services here.

9. NovaMed. NovaMed acquires, develops and operates ASCs in partnership with physicians, and provides expertise in identifying and attracting new physicians to perform surgical procedures in existing ASCs. Last year, Novamed-owned centers (for more than one year) grew 7 percent, which is the highest same-facility growth rate in the industry. Novamed is sponsoring the Friday-morning continental breakfast. For a complete profile, go here.

10. Facility Development and Management. Facility Development and Management is a for-profit LLC that provides consultative, developmental and managerial services for ASCs. The primary objectives of Facility Development and Management are to identify business opportunities; formulate project plans; guide and direct facilities through the planning, construction, set-up and licensure phases of the project; and provide ongoing administrative and clinical support. The company is sponsoring Friday's continental breakfast. Read more about Facility Development and Management here.

If you are a Becker's ASC Review paid subscriber, you are entitled to the following new benefits:

1. Becker's ASC Review delivered to your door.
   
2. Subscriber discounts on the cost of audio conference and Webinar registrations.
   
3. $100 off registration for both main and pre-conference sessions at the June conference.
   
4. $50 off registration for both main and pre-conference sessions at the October conference.
   
5. Free copy of the VMG Health Intellimarker benchmarking survey, an extremely valuable guide.

To subscribe to the Becker's ASC Review go to www.BeckersASC.com.